CHICAGO (Reuters) - Women who survive
breast cancer after undergoing chemotherapy may also have to contend with
impairments in attention, memory and planning skills, U.S. researchers said on
Monday.
They said women who had undergone chemotherapy
for breast cancer had significantly less activity in parts of the brain
responsible for executive functioning tasks compared with breast cancer
patients who were not treated with chemotherapy.
Among those treated with chemotherapy, the
study also found a strong correlation between women who complained they were
having trouble with memory and thinking skills and actual deficits in these
regions of the brain.
The study may help explain why many breast
cancer patients complain of "chemo brain" -- a term used to describe
foggy thinking and memory lapses following treatment with chemotherapy.
"This is a huge validation for these
women who are telling their doctors 'something is wrong with me'," said
Shelli Kesler of Stanford University School of Medicine in California, whose
study appears in the Archives of Neurology.
Kesler said the conventional thinking is that
chemotherapy drugs cannot cross a protective membrane called the blood-brain
barrier that protects the brain from toxins.
And doctors have dismissed women's complaints
of brain deficits after chemotherapy, chalking them up to exaggeration and
stress related to the cancer.
"This shows that when a patient reports
she's struggling with these types of problems, there's a good chance there has
been a brain change," Kesler said.
Her study involved 25 breast cancer patients
who had been treated with chemotherapy, 19 breast cancer patients who had
surgery and other treatments, and 18 healthy women.
All were asked to perform a card-sorting task
that involves problem-solving skills while their brain activity was monitored
through functional magnetic resonance imaging or fMRI.
The women also completed questionnaires to
assess their own cognitive abilities.
As in prior studies of cancer patients, the
team saw significant reductions in activity in two parts of the prefrontal
cortex, including one used for working memory, cognitive control and
monitoring.
But they also found significantly reduced
activation of an additional region of the prefrontal cortex linked with
executive function -- the area of the brain needed for planning.
Women in the chemotherapy group were also
found to make more errors on the card-sorting task and take longer to complete
it than healthy women and cancer patients who were not treated with
chemotherapy.
While a finding in 25 women seems small,
Kesler said it is large for a brain scan study and points to a need to start
identifying which women who undergo chemotherapy are most vulnerable to these
types of deficits.
She said future studies should be done in
which women are tested before they undergo chemotherapy to determine the impact
of treatment on brain function.
Women are increasingly surviving their breast
cancer, with breast cancer survivors comprising 22 percent of the nearly 12
million cancer survivors in the United States, according to the Centers for
Disease Control and Prevention.
Julie Steenhuysen | Reuters
(Editing by Eric Walsh)
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